The Importance of Patency in Patients with Critical Limb Ischemia Undergoing Endovascular Revascularization for Infrapopliteal Arterial Disease.

Baumann, Frederic; Ozdoba, Christoph; Gröchenig, Ernst; Diehm, Nicolas (2014). The Importance of Patency in Patients with Critical Limb Ischemia Undergoing Endovascular Revascularization for Infrapopliteal Arterial Disease. Frontiers in cardiovascular medicine, 1(17), p. 17. Frontiers 10.3389/fcvm.2014.00017

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Critical limb ischemia (CLI) represents the most severe form of peripheral arterial disease (PAD) and frequently occurs in medically frail patients. CLI patients frequently exhibit multi-segmental PAD commonly including the tibial arterial segment. Endovascular therapy has been established as first-line revascularization strategy for most CLI patients. Restenosis was reported to occur in up to more than two-thirds of CLI patients undergoing angioplasty of complex tibial arterial obstructions. Nevertheless, favorable clinical outcomes were observed for infrapopliteal angioplasty when compared with bypass surgery, despite higher patency rates for the latter. Based on these observations, infrapopliteal patency was considered to be only of secondary importance upon clinical outcomes in CLI patients. In contrast to these earlier observations, however, recent findings from two randomized clinical trials indicate that infrapopliteal patency does impact on clinical outcomes in CLI patients. The purpose of the present manuscript is to provide a critical reappraisal of the present literature on the clinical importance of tibial arterial patency in CLI patients undergoing endovascular revascularization and to discuss utility and limitations of currently available anti-restenosis technologies.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology

UniBE Contributor:

Ozdoba, Christoph

Subjects:

600 Technology > 610 Medicine & health

ISSN:

2297-055X

Publisher:

Frontiers

Language:

English

Submitter:

Martin Zbinden

Date Deposited:

08 Jan 2016 13:09

Last Modified:

26 Jun 2016 02:09

Publisher DOI:

10.3389/fcvm.2014.00017

PubMed ID:

26664867

Uncontrolled Keywords:

below the knee; critical limb ischemia; endovascular revascularization; patency

BORIS DOI:

10.7892/boris.74579

URI:

https://boris.unibe.ch/id/eprint/74579

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